HEALTH CARE/Joan Retsinas

Taxes for Your Health

Lower taxes. That is the mantra, the promise, the slogan bandied about in this election campaign. The Republicans added a corollary cry: Less government. Government emerges as The Great Hobbler, stifling Main Street with regulations-without-end. The political right wants to stifle government.
Consider this essay a grateful ode to regulations, and to the taxes that support an intrusive government. We take medicines, we jog, we eat tofuall for our health. Taxes are just as essential.
In the spirit of Frank Capras Its A Wonderful Life, consider a world without governmental interventions.

No Government Interference in the Pharmaceutical Market
In an unregulated pharmaceutical industry, unfettered by pesky government demands for clinical trials upon trials, anybody could market any elixir. That was the case 100 years ago when wizards touted their patent medicines. Consumers judged drugs effectiveness from personal anecdotes and marketing babbleno scientific studies needed.
Consider recent governmental meddling in this market. In October the Food and Drug Administration joined with professional associations to force manufacturers of over-the-counter cough medicines to stop marketing the syrups to young children. The rationale: the syrups had never been tested on young children. The government warned Laboratory Corporation of America Holdings not to market OvaSure, its test for ovarian cancer: the government asserts that the test yields too many false negatives, false positives.
Congress stepped into the intrusion-arena. It seeks to hamstring the rogue Internet pharmacies that sell anything to anybody who can click onto cyberspace. That law will keep all of us, including the teenagers and addicts among us, from getting the drugs we want, cheap and quickly, without the bother of a verifiable prescription (just as six months ago in the unregulated world of finance it was so easy to click onto a nifty subprime mortgage).
How meddlesomely intrusive!

No Government Dollars for Research
Name a disease, any disease. Trace the dollars propelling research. The bulk comes from the government. The government expects no immediate payback: many studies take researchers down dead ends, forcing them to reassess, re-hypothesize, retest data. For some diseases, generations of researchers have been searching to understand the etiology, much less develop a cure.
The notion that private philanthropy will substitute for government spending is ludicrous. Philanthropists subsidize museums, theaters, orchestras, hospitals, libraries, universities  the government cannot dictate the flow of private dollars. Imagine that in a populist zeal to cut taxes we abolished the National Institutes of Health. Plausibly, more private money might flow into medical research, but certainly not enough to compensate.
As for the private for-profit market investing in basic biomedical research, the payback is too iffy, too distant to warrant that kind of investment. Indeed, pharmaceutical companies focus on developing drugs most likely to yield a profit (like the newest statin for high cholesterol), not the experimental drugs least likely to be profitable.
We dont have cures, or sure-fire treatments, for a host of diseases. But without government money, we wont ever have them.

Dirtier Air, Water, and Food
The government now tries to pounce, more or less effectively, on the cars spewing carbon into the air, the factories discharging wastes into rivers, the restaurants serving contaminated food.
Obviously businesses dont welcome that oversight. That oversight raises their costs. But it is the patrons who breathe the air, drink the water, and eat the food who want the oversight.
Without regulations and monitoring, the public would depend on the good will of the private sector. The private sector, though, has a clear mandate: to make a profit. Shareholders expect no less. If protecting the public depletes profits, the public will lose.
In this economic downturn, states will see their tax revenues drop. Governors and legislators will want to eviscerate health departments, cutting back on the employees who inspect cars, restaurants, rivers, and air quality. Taxpayers will be paying in ill-health for that savings.
Maybe we should write ourselves a prescription for taxesif only we could afford them.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.